| NPI | 1528352549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD165377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 16719) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2023-11-16 |